ACA isn’t perfect, but it’s an improvement over nothing

Let’s face it. America’s complex and profit-driven system of medical care is broken and always has been. Attempts to fix it piece by piece in a political system that fumbles and stumbles its way through an obsession with winning elections — and with maintaining powerful public office — will always fail.

The high quality of our medical care available to those who can afford it, driven by excellence in medical education and research and by technological advances, cannot overcome its spotty and illogical availability.

The deeply embedded fear of losing an election, requiring a sinful amount of funding, which must be provided by the powerful interests with the requisite funds, will always forestall the only workable system of medical care. That is the single-payer model that serves most other advanced societies so well.

We should know this because we have a version of a single-payer system that works well — the very popular Medicare that many of those not directly involved seem to ignore.

So even when the political system is under intense pressure to do something to come to grips with the problem, it comes up with a complex and perhaps unworkable structure created through compromise after compromise.

Thus the Affordable Care Act is now what we’re stuck with. It’s imperfect, but it’s all we’ve got, and it is in many ways better than what we had before it arrived on the scene.

Unfortunately our election-obsession has squeezed political parties into dealing with it based on whether it can be used to “beat the other guys” — not on whether it’s an improvement over alternative solutions.

So I guess we’re faced with the choice of either living with it and tinkering with it to improve it, or abandoning it and returning to a system of unregulated greed-driven medical care financing.